TREATMENT OPTIONS FOR ERECTILE DYSFUNCTION
Vardenafil HCl (Levitra™) has a half-life of 4.7 h, a value not dissimilar from that of sildenafil (Viagra®). At a dose of 20 mg, up to 85% of men reported significant improvement in erections at 26 weeks compared with 28% of men who received placebo. Similar to sildenafil, vardenafil seems effective even in challenging patient groups such as those with diabetes mellitus or post-prostatectomy erectile dysfunction. Side-effects include headache and facial flushing, and, like sildenafil (Viagra ®) and tadalafil (Cialis™), vardenafil (Levitra™) should not be used in conjunction with any form of nitrate therapy. Because of its mild hypotensive effect, vardenafil (Levitra™) should not be taken in conjunction with α-blockers, such as terazosin. In addition, vardenafil (Levitra™) has been shown to produce minor prolongation of the QT interval and, as a consequence, should be avoided in patients with congenital QT prolongation and those taking Class 1A (e.g. quinidine, procainamide) or Class III (e.g. amiodarone, sotalol) antiarrhythmic medications.
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Unfortunately, many health-care practitioners are still too embarrassed to discuss sexual problems frankly and, as a consequence, avoid raising these issues with their patients. The onus now falls on those who care for the many patients with erectile dysfunction to initiate the discussion and to inform and instruct them and their partners as to the cause of their problem, and the safest and most effective means by which natural erectile function may be restored and sexual activity resumed.
